仰卧整复法治疗颈椎不稳所致颈性眩晕的经颅多普勒超声和X线观察

An transcranial Doppler ultrasonography and X-ray study of cervical vertigo patients treated by manipulation in supine position

目的 观察仰卧整复手法治疗颈椎不稳所致颈性眩晕患者的经颅椎动脉多普勒超声和颈椎侧位X线摄片的变化 ,探讨其治疗颈性眩晕的可能机制。方法 回顾分析仰卧整复手法治疗颈椎不稳所致颈性眩晕患者 16例 ,观察手法治疗的效果及手法治疗前后患者经颅椎动脉多普勒超声和颈椎侧位X线摄片椎体间的位移变化 ,并和正常人群进行比较。结果 16例患者治疗前椎动脉平均血流速度为 (48.6± 3.1)cm/s ,显著高于同龄正常人群 (P <0 .0 5 ) ;仰卧整复手法治疗后椎动脉平均血流速度为 (39.2± 3.5 )cm/s ,较治疗前有显著下降 (P <0 .0 5 )。治疗前颈椎侧位X线摄片示C3 ,4间的位移为 (3.18±0 .4 2 )mm ,C4,5间的位移为 (3.4 6± 0 .2 6 )mm ;治疗后分别为 (2 .2 5± 0 .35 )mm和 (3.2 8± 0 .35 )mm ,C3 ,4间的位移明显减少 (P<0 .0 5 )。手法治疗效果评价 :10例痊愈 ;4例显效 ;2例有效。结论 仰卧整复手法是治疗颈椎不稳所致颈性眩晕的有效手法 。

Objective To observe the transcranial Doppler ultrasonography and X-ray changes of cervical vertigo patients caused by cervical instability before and after the manipulation treatment in supine position. Methods Sixteen cervical vertigo patients who underwent supine manipulation treament were reviewed retrospectively. After the treatment, the changes of transcranial Doppler ultrasonography of cervical vertebral artery and X-ray of cervical spine were observed. Results Before the treatment, the mean blood flow velocity of vertebral artery was (48.6±3.1)cm/s,much higher than that of the normal group (P <0.05), the means of the horizontal displacement of C 3,4 and C 4,5 were (3.18±0.42)mm and (3.46±0.26)mm respectively. After the treatment,the blood flow velocity and the C 3,4 horizontal displacement decreased significantly (P <0.05). The effective rate of the manipulation treatment was 100%. Conclusion The manipulation treatment is an effective method for cervical vertigo patients caused by cervical instability,and the effect is correlated with the improvement of the blood flow of cervical artery and the restoration of cervical stability.